One father of an autistic child, Jonathan Shestack, describes what happened
to his son, Dov, as "watching our sweet, beautiful boy disappear
in front of our eyes." At two, Dov's first words - Mom, Dad, flower,
park - abruptly retreated into silence. Over the next six months,
Dov ceased to recognize his own name and the faces of his parents. It took
Dov a year of intensive behavioral therapy to learn how to point. At age
9, after the most effective interventions available (such as the step-by-step
behavioral training methods developed by Ivar Lovaas at UCLA), Dov can
speak 20 words.

Even children who make significant progress require levels of day-to-day
attention from their families that can best be described as heroic. Marnin
Kligfeld is the founder of a software mergers-and-acquisitions firm. His
wife, Margo Estrin, a doctor of internal medicine, is the daughter of Gerald
Estrin, who was a mentor to many of the original architects of the Internet
(see "Meet the Bellbusters,"
Wired 9.11, page 164). When
their daughter, Leah, was 3, a pediatrician at Oakland Children's Hospital
looked at her on the examining table and declared, "There is very little
difference between your daughter and an animal. We have no idea what she
will be able to do in the future." After eight years of interventions -
behavioral training, occupational therapy, speech therapy - Leah is a happy,
upbeat 11-year-old who downloads her favorite songs by the hundreds. And
she is still deeply autistic.

Leah's first visit to the dentist required weeks of preparation, because
autistic people are made deeply anxious by any change in routine. "We took
pictures of the dentist's office and the staff, and drove Leah past the
office several times," Kligfeld recalls. "Our dentist scheduled us for
the end of the day, when there were no other patients, and set goals with
us. The goal of the first session was to have Leah sit in the chair. The
second session was so Leah could rehearse the steps involved in treatment
without actually doing them. The dentist gave all of his equipment special
names for her. Throughout this process, we used a large mirror so Leah
could see exactly what was being done, to ensure that there were no surprises."

Daily ordeals like this, common in the autistic community, underline the
folly of the hypothesis that prevailed among psychologists 20 years ago,
who were convinced that autism was caused by a lack of parental affection.
The influential psychiatrist Bruno Bettelheim aggressively promoted a theory
that has come to be known as the "refrigerator mother" hypothesis. He declared
in his best-selling book, The Empty Fortress, "The precipitating
factor in infantile autism is the parent's wish that his child should not
exist. ... To this the child responds with massive withdrawal." He prescribed
"parentectomy" - removal of the child from the parents - and years of family
therapy. His hypothesis added the burden of guilt to the grief of having
an autistic child, and made autism a source of shame and secrecy, which
hampered efforts to obtain clinical data. The hypothesis has been thoroughly
discredited. Richard Pollak's The Creation of Dr. B exposed
Bettelheim as a brilliant liar who concocted case histories and exaggerated
both his experience with autistic children and the success of his treatments.

One thing nearly everyone in the field agrees on: genetic predisposition. Identical twins share the disorder 9 times out of 10.

But the debates about the causes of autism are certainly not over.
Controversies
rage about whether environmental factors - such as mercury and other chemicals
in universally administered vaccines, industrial pollutants in air and
water, and even certain foods - act as catalysts that trigger the disorder.
Bernard Rimland, the first psychologist to oppose Bettelheim and promote
the idea that autism was organic in origin, has become a leading advocate
for intensified investigation in this area. The father of an autistic son,
Rimland has been instrumental in marshaling medical expertise and family
data to create better assessment protocols.

The one thing that almost all researchers in the field agree on is that
genetic predisposition plays a crucial role in laying the neurological
foundations of autism in most cases. Studies have shown that if one identical
twin is autistic, there's a 90 percent chance that the other twin will
also have the disorder. If parents have had one autistic child, the risk
of their second child being autistic rises from 1 in 500 to 1 in 20. After
two children with the disorder, the sobering odds are 1 in 3. (So many
parents refrain from having more offspring after one autistic child,
geneticists even have
a term for it: stoppage.) The chances that the siblings
of an autistic child will display one or more of the other developmental
disorders with a known genetic basis - such as dyslexia or Tourette's syndrome
- are also significantly higher than normal.

The bad news from Santa Clara County raises an inescapable question. Unless
the genetic hypothesis is proven false, which is unlikely, regions with
a higher than normal distribution of people on the autistic spectrum are
something no researcher could ask for: living laboratories for the study
of genetic expression. When the rain that fell on the Rain Man falls harder
on certain communities than others, what becomes of the children?

The answer may be raining all over Silicon Valley. And one of the best
hopes of finding a cure may be locked in the DNA sequences that produced
the minds that have made this area the technological powerhouse of the
world.

It's a familiar joke in the industry that many of the hardcore programmers
in IT strongholds like Intel, Adobe, and Silicon Graphics - coming to work
early, leaving late, sucking down Big Gulps in their cubicles while they
code for hours - are residing somewhere in Asperger's domain. Kathryn Stewart,
director of the Orion Academy, a high school for high-functioning kids
in Moraga, California, calls Asperger's syndrome "the engineers' disorder."
Bill Gates is regularly diagnosed in the press: His single-minded
focus on technical minutiae, rocking motions, and flat tone of voice
are all suggestive of an adult with some trace of the disorder. Dov's father
told me that his friends in the Valley say many of their coworkers "could
be diagnosed with ODD - they're odd." In Microserfs, novelist
Douglas Coupland observes, "I think all tech people are
slightly autistic."